			Home About us Contact

Health Facilities (health + facility)

Distribution by Scientific Domains

Medical Sciences	70%
Psychology	15%
Business, Economics, Finance and Accounting	10%

Distribution within Medical Sciences

Pediatrics	21%
Nursing General	14%

Kinds of Health Facilities

mental health facility

Selected Abstracts

Infrastructure and Rural Development: US and EU Perspectives Infrastruktur und Entwicklung des ländlichen Raums: Perspektiven aus den USA und der EU Infrastructures et développement rural : Perspectives aux États-Unis et dans l'Union européenne

EUROCHOICES, Issue 1 2008
David Blandford
Infrastructure and Rural Development: US and EU Perspectives Infrastructural development remains a cornerstone of rural development policy in both the United States and Europe. It is evident that rural development objectives differ, but similar policy measures are used. The economic rationale for infrastructure development centres on efficiency and creation of competitive advantage. Policy intervention is justified because of the added costs of infrastructure provision in remote, sparsely populated areas. Although this policy focus does not guarantee success, regions leading in economic development typically have better physical infrastructure. In the United States, policy must adapt to challenges posed by an ageing rural infrastructure and demographic change that will increase demands on social infrastructure such as housing and health facilities. There will be greater local responsibility for funding, and expanded use of public/private partnerships. In the European Union, the major challenge is in redirecting resources to new member states, where there is urgent need for both large new investments in transport networks and small investments to improve local access. Although two current options for funding these diverse needs focus on European policies only, investments in non-farm physical capital and public infrastructure cannot be sustained without active national policies to complement the European efforts, perhaps through co-financing requirements. Infrastructures et développement rural : Perspectives aux États-Unis et dans l'Union européenne Le développement des infrastructures demeure un pilier de la politique de développement rural aux États-Unis comme dans l'Union européenne. Les objectifs de développement rural diffèrent bien évidemment mais des mesures semblables sont employées. La justification économique du développement des infrastructures repose sur l'efficience et la création d'avantages concurrentiels. L'intervention publique est justifiée par les coûts supplémentaires des infrastructures dans les zones éloignées à population clairsemée. Bien que ce type de politique ne garantisse pas le succès, les régions en avance de développement économique ont en général de meilleures infrastructures physiques. Aux États-Unis, la politique soit s'adapter aux défis que posent le vieillissement des infrastructures rurales et l'évolution démographique qui va augmenter la demande d'infrastructures sociales telles que les services de santé et de logement. La responsabilité du financement local va augmenter et les partenariats public/privé vont se développer. Dans l'Union européenne, le principal défi est de réorienter les ressources vers les nouveaux pays membres qui ont un besoin urgent de nouveaux investissement d'ampleur dans les réseaux de transport et d'investissement de plus faible ampleur dans l'amélioration des accès locaux. Deux options actuelles de financement de ces divers besoins se concentrent sur les seules politiques européennes, mais les investissements dans le capital physique non agricole et dans les infrastructures publiques ne peuvent pas se poursuivre sans des politiques nationales actives complémentant les efforts fournis au niveau européen, peut-être à travers des mécanismes de co-financement. Infrastruktur und Entwicklung des ländlichen Raums: Perspektiven aus den USA und der EU Bei der Entwicklung der Infrastruktur handelt es sich nach wie vor sowohl in den USA als auch in Europa um einen Eckpfeiler in der Politik zur Entwicklung des ländlichen Raums. Es ist offensichtlich, dass sich die Ziele bei der Entwicklung des ländlichen Raums unterscheiden, die Politikmaßnahmen ähneln sich jedoch. Die wirtschaftliche Begründung für die Entwicklung der Infrastruktur zielt auf die Effizienz und das Schaffen von Wettbewerbsvorteilen ab. Politikeingriffe sind gerechtfertigt, da die Bereitstellung von Infrastruktur in entlegenen, dünn besiedelten Gebieten höhere Kosten verursacht. Obgleich dieser Schwerpunkt der Politik den Erfolg noch nicht garantiert, verfügen die wirtschaftlich am weitesten entwickelten Regionen typischerweise über eine bessere physische Infrastruktur. In den USA muss sich die Politik an die Herausforderungen anpassen, welche eine in die Jahre gekommene Infrastruktur im ländlichen Raum und der demografische Wandel mit sich bringen, und wodurch neue Anforderungen an die soziale Infrastruktur, wie z.B. Wohnungsbau und Gesundheitseinrichtungen, gestellt werden. Bei der Finanzierung werden die Kommunen stärker in die Verantwortung genommen, und öffentlich-private Partnerschaften werden an Bedeutung gewinnen. In der EU besteht die größte Herausforderung darin, Ressourcen zu den neuen Mitgliedstaaten umzuverteilen, wo sowohl neue Großinvestitionen in die Transportnetzwerke als auch kleinere Investitionen zur Verbesserung des lokalen Zugangs dringend benötigt werden. Obwohl sich die beiden im Moment vorhandenen Optionen zur Finanzierung dieser vielfältigen Bedürfnisse ausschließlich auf europäische Politikmaßnahmen konzentrieren, können die Investitionen in außerlandwirtschaftliches physisches Kapital und in die öffentliche Infrastruktur nicht ohne wirksame Politikmaßnahmen auf nationaler Ebene (z.B. die Pflicht zur Kofinanzierung) als Ergänzung zu den Bemühungen auf europäischer Ebene aufrecht erhalten werden. [source]

Expenditure Incidence in Africa: Microeconomic Evidence

FISCAL STUDIES, Issue 3 2000
David E. Sahn
Abstract In this paper, we examine the progressivity of social sector expenditures in eight sub-Saharan African countries. We employ dominance tests, complemented by extended Gini/concentration coefficients, to determine whether health and education expenditures redistribute resources to the poor. We find that social services are poorly targeted. Among the services examined, primary education tends to be most progressive and university education is least progressive. The benefits associated with hospital care are also less progressive than other health facilities. Our results also show that, while concentration curves are a useful way to summarise information on the distributional benefits of government expenditures, statistical testing of differences in curves is important. [source]

Quality improvement and its impact on the use and equality of outpatient health services in India

HEALTH ECONOMICS, Issue 8 2007
Krishna Dipankar Rao
Abstract This paper examines the impact of quality improvements in conjunction with user fees on the utilization and equality of outpatient services at a range of public sector health facilities in India. Project impact on outpatient visits was estimated via the difference-in-difference method using pooled time series visit data from project and control facilities. The results indicate that the quality improvements significantly increased visits at all facility types. The project effect was largest at primary health center (PHC) and community health center (CHC), followed by district hospital (DH) and female district hospital (FDH). Pro-rich inequalities in outpatient visits increased at DHs and FDHs while at CHCs and PHCs the distribution remained equitable. This suggests that quality improvements at public sector health facilities can increase utilization of outpatient services in the presence of nominal user fees, but can also promote greater inequality favoring the better-off. At the referral hospital level, quality improvements should be made in conjuction with programs which encourage utilization by the poor. In contrast, the benefit of quality improvements at PHCs and CHCs is equitably distributed. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Changing medical doctor productivity and its affecting factors in rural China

INTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 2 2004
Tim Martineau
Abstract Using the data collected from the health facility-based survey, part of the national health service survey conducted in 1993 and 1998, this paper tries to examine changes in labour productivity among the county-level hospitals and township health centres in rural China, and to analyse factors affecting the changes. The results presented in the paper show that the average number of outpatient visits per doctor per day and the average number of inpatient days per doctor per day declined significantly over the period from 1986 to 1997. The main factors resulting in the reduction of productivity are associated with the increase of inappropriate staff recruitment in these health facilities, the significant decline of rural population covered by health insurance, particularly rural cooperative medical schemes (CMS), and the rapid rise of health care costs. The latter two factors also have brought about a reduction in the use of these health facilities by the rural population. The paper suggests that the government should tighten up the entrance of health and non-health staff into the rural health sector and develop effective measures aimed to avoid providing pervasive financial incentives to the over-provision of services and over-use of drugs. In addition, other measures that help to increase the demand for health services, such as the establishment of rural health insurance, should be considered seriously. Copyright © 2004 John Wiley & Sons, Ltd. [source]

Prescription practices of public and private health care providers in Attock District of Pakistan

INTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 1 2002
S. Siddiqi
Abstract The irrational use of drugs is a major problem of present day medical practice and its consequences include the development of resistance to antibiotics, ineffective treatment, adverse effects and an economic burden on the patient and society. A study from Attock District of Pakistan assessed this problem in the formal allopathic health sector and compared prescribing practices of health care providers in the public and private sector. WHO recommended drug use indicators were used to study prescription practices. Prescriptions were collected from 60 public and 48 private health facilities. The mean (±,SE) number of drugs per prescription was 4.1,±,0.06 for private and 2.7,±,0.04 for public providers (,p,<,0.0001). General practitioners (GPs) who represent the private sector prescribed at least one antibiotic in 62% of prescriptions compared with 54% for public sector providers. Over 48% of GP prescriptions had at least one injectable drug compared with 22.0% by public providers (,p,<,0.0001). Thirteen percent of GP prescriptions had two or more injections. More than 11% of GP prescriptions had an intravenous infusion compared with 1% for public providers (,p,<,0.001). GPs prescribed three or more oral drugs in 70% of prescriptions compared with 44% for public providers (,p,<,0.0001). Prescription practices were analysed for four health problems, acute respiratory infection (ARI), childhood diarrhoea (CD), fever in children and fever in adults. For these disorders, both groups prescribed antibiotics generously, however, GPs prescribed them more frequently in ARI, CD and fever in children (,p,<,0.01). GPs prescribed steroids more frequently, however, it was significantly higher in ARI cases (,p,<,0.001). For all the four health problems studied, GPs prescribed injections more frequently than public providers (,p,<,0.001). In CD cases GPs prescribed oral rehydration salt (ORS) less frequently (33.3%) than public providers (57.7%). GPs prescribed intravenous infusion in 12.3% cases of fever in adults compared with none by public providers (,p,<,0.001). A combination of non-regulatory and regulatory interventions, directed at providers as well as consumers, would need to be implemented to improve prescription practices of health care providers. Regulation alone would be ineffective unless it is supported by a well-established institutional mechanism which ensures effective implementation. The Federal Ministry of Health and the Provincial Departments of Health have to play a critical role in this respect, while the role of the Pakistan Medical Association in self-regulation of prescription practices can not be overemphasized. Improper prescription practices will not improve without consumer targeted interventions that educate and empower communities regarding the hazards of inappropriate drug use. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Home clinic programme: An alternative model for private mental health facilities and sufferers of major depression

INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 1 2006
Eddie Blacklock
ABSTRACT:, Depression demands high emotional and social costs to people suffering it while private hospitals and health funds are economically affected in respect to elongated episodes of care and readmission rates. There is a dearth of nurse-led initiatives aimed to reduce length of stay. An innovative model of care is proposed, offering the opportunity for depressed clients to return home earlier from hospital where they will receive the professional guidance and support of mental health registered nurses (RNs) providing contemporary counselling. Clinical links between the home and the hospital would be maintained by the RNs for a specified time frame. The framework of home clinic programme is to discharge clients from hospital into community within specified time frame (maximum 14 days hospitalization) and the clients will be visited by RNs in their homes five times in the first week, twice in the second week and once in the third week to ascertain their emotional and clinical needs and provide biopsychosocial support. The use of this model has potential benefits for mental health consumers, clinicians, services, and funders. [source]

Using participatory methods and geographic information systems (GIS) to prepare for an hiv community-based trial in Vulindlela, South Africa (Project Accept,HPTN 043),,

JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 1 2009
Admire Chirowodza
Recent attempts to integrate geographic information systems (GIS) and participatory techniques, have given rise to terminologies such as participatory GIS and community-integrated GIS. Although GIS was initially developed for physical geographic application, it can be used for the management and analysis of health and health care data. Geographic information systems, combined with participatory methodology, have facilitated the analysis of access to health facilities and disease risk in different populations. Little has been published about the usefulness of combining participatory methodologies and GIS technology in an effort to understand and inform community-based intervention studies, especially in the context of HIV. This article attempts to address this perceived gap in the literature. The authors describe the application of participatory research methods with GIS in the formative phase of a multisite community-based social mobilization trial, using voluntary counseling and testing and post-test support as the intervention. © 2008 Wiley Periodicals, Inc. [source]

Staff survey results and characteristics that predict assault and injury to personnel working in mental health facilities

AGGRESSIVE BEHAVIOR, Issue 1 2003
Julie Cunningham
Abstract The purpose of this study was to complete a mental health staff opinion survey to identify patient and staff characteristics associated with staff assault and injury in psychiatric treatment settings and to develop a model of prediction for staff assault and injury utilizing these survey variables. The data consisted of opinion surveys sent to staff of 15 child, adolescent, and adult psychiatry inpatient units in the United States. Multivariate logistic regression was used to determine the level of assault and staff-reported injury prediction that could be obtained from the staff-completed opinion survey. Responses indicated a high prevalence of reported aggression, with 62.3% of staff endorsing verbal and physical aggression, property destruction, and self-injurious behavior as being prevalent at their site, whereas only 4.1% rated none of these as prevalent. Staff working with children and adolescents in settings with high rates of psychiatric diagnoses reported increased frequency of assault and injury compared with those working with adults. Younger, less experienced staff reported higher rates of assault and injury. Staff working with female patients reported similar rates of assault and injury to those working with males. A logistic regression analysis using staff-reported survey results of both staff and patient characteristics predicted assault correctly 73.7% of the time and injury 66.1% of the time. Resources for violence prevention and staff training programs in violence prevention are needed in child and adolescent psychiatry wards. Results are consistent with theories emphasizing the importance of negative emotions and affects, impulsivity, and frustration in goal-directed activities in human aggression. Aggr. Behav. 29:31,40, 2003. © 2003 Wiley-Liss, Inc. [source]

Effects of HIV/AIDS on Maternity Care Providers in Kenya

JOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 5 2008
Janet M. Turan
ABSTRACT Objective: To explore the impact of HIV/AIDS on maternity care providers in labor and delivery in a high HIV-prevalence setting in sub-Saharan Africa. Design: Qualitative one-on-one in-depth interviews with maternity care providers. Setting: Four health facilities providing labor and delivery services (2 public hospitals, a public health center, and a small private maternity hospital) in Kisumu, Nyanza Province, Kenya. Participants: Eighteen maternity care providers, including 14 nurse/midwives, 2 physician assistants, and 2 physicians (ob/gyn specialists). Results: The HIV/AIDS epidemic has had numerous adverse effects and a few positive effects on maternity care providers in this setting. Adverse effects include reductions in the number of health care providers, increased workload, burnout, reduced availability of services in small health facilities when workers are absent due to attending HIV/AIDS training programs, difficulties with confidentiality and unwanted disclosure, and maternity care providers' fears of becoming HIV infected and the resulting stigma and discrimination. Positive effects include improved infection control procedures on maternity wards and enhanced maternity care provider knowledge and skills. Conclusion: A multifaceted package including policy, infrastructure, and training interventions is needed to support maternity care providers in these settings and ensure that they are able to perform their critical roles in maternal healthcare and prevention of HIV/AIDS transmission. [source]

Critical appraisal of the management of severe malnutrition: 1.

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 10 2006
Epidemiology, treatment guidelines
Abstract: Hospital case-fatality rates for severe malnutrition in the developing world remain high, particularly in Africa where they have not changed much over recent decades. In an effort to improve case management, WHO has developed treatment guidelines. The aim of this review is to critically appraise the evidence for the guidelines and review important recent advances in the management of severe malnutrition. We conclude that not only is the evidence base deficient, but also the external generalisability of even good-quality studies is seriously compromised by the great variability in clinical practice between regions and types of health facilities in the developing world, which is much greater than between developed countries. The diagnosis of severe wasting is complicated by the dramatic change in reference standards (from CDC/WHO 1978 to CDC 2000 in EpiNut) and also by difficulties in accurate measurement of length. Although following treatment guidelines has resulted in improved outcomes, there is evidence against the statement that case-fatality rates (particularly in African hospitals) can be reduced below 5% and that higher rates are proof of poor practice, because there is wide variation in severity of illness factors. The practice of prolonged hospital treatment of severe malnutrition until wasting and/or oedema has resolved is being replaced by shorter hospital stays combined with outpatient or community follow-up because of advances in dietary management outside of hospital. [source]

Identifying service needs of children with disruptive behavior problems using a Nominal Group Technique

NURSING & HEALTH SCIENCES, Issue 4 2000
Diana R. Keatinge RN, M ADMIN
Abstract A recent study used both qualitative and quantitative methods to examine families' perceptions of service needs for children with disruptive behavior problems. Focusing on the qualitative component of the study, the present paper discusses the modified Nominal Group Technique used in focus groups attended by carers living in rural, regional or metropolitan contexts. Three questions posed to each focus group sought to identify families' concerns about health facilities and/or related support services currently available to them, the benefits they perceived in these services and the changes needed to make these services more appropriate or accessible to them. Major themes in the responses relating to each of these questions included concerns about a lack of, or perceived need for, access to help/support, benefits in schools that accommodated the needs of the children, and support from the community. Families' recommendations for change included increased access to health care advice, information and/or support systems. [source]

Maternal height and child mortality in 42 developing countries

AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 3 2009
Christiaan W. S. Monden
Previous research reports mixed results about the association between maternal height and child mortality. Some studies suggest that the negative association might be stronger in contexts with fewer resources. This hypothesis has yet not been tested in a cross-nationally comparative design. We use data on 307,223 children born to 194,835 women in 444 districts of 42 developing countries to estimate the association between maternal height and child mortality and test whether this association is modified by indicators at the level of the household (like sex, age and twin status of the child and socio-economic characteristics of the mother and her partner), district (regional level of development, public health facilities and female occupational attainment) and country (GDP per capita). We find a robust negative effect of logged maternal height on child mortality. The effect of maternal health is strongest for women with least education and is more important in the first year after birth and for twin births. The indicators of development at the district and country level do not modify the effect of maternal height. Am. J. Hum. Biol. 2009. © 2008 Wiley-Liss, Inc. [source]

Evaluation of a mental health treatment court with assertive community treatment,

BEHAVIORAL SCIENCES & THE LAW, Issue 4 2003
Merith Cosden Ph.D.
Without active engagement, many adults with serious mental illnesses remain untreated in the community and commit criminal offenses, resulting in their placement in the jails rather than mental health facilities. A mental health treatment court (MHTC) with an assertive community treatment (ACT) model of case management was developed through the cooperative efforts of the criminal justice and mental health systems. Participants were 235 adults with a serious mental illness who were booked into the county jail, and who volunteered for the study. An experimental design was used, with participants randomly assigned to MHTC or treatment as usual (TAU), consisting of adversarial criminal processing and less intensive mental health treatment. Results were reported for 6 and 12 month follow-up periods. Clients in both conditions improved in life satisfaction, distress, and independent living, while participants in the MHTC also showed reductions in substance abuse and new criminal activity. Outcomes are interpreted within the context of changes brought about in the community subsequent to implementation of the MHTC. Copyright © 2003 John Wiley & Sons, Ltd. [source]

Perinatal services and outcomes in Quang Ninh province, Vietnam

ACTA PAEDIATRICA, Issue 10 2010
Nguyen T Nga
Abstract Aim:, We report baseline results of a community-based randomized trial for improved neonatal survival in Quang Ninh province, Vietnam (NeoKIP; ISRCTN44599712). The NeoKIP trial seeks to evaluate a method of knowledge implementation called facilitation through group meetings at local health centres with health staff and community key persons. Facilitation is a participatory enabling approach that, if successful, is well suited for scaling up within health systems. The aim of this baseline report is to describe perinatal services provided and neonatal outcomes. Methods:, Survey of all health facility registers of service utilization, maternal deaths, stillbirths and neonatal deaths during 2005 in the province. Systematic group interviews of village health workers from all communes. A Geographic Information System database was also established. Results:, Three quarters of pregnant women had ,3 visits to antenatal care. Two hundred and five health facilities, including 18 hospitals, provided delivery care, ranging from 1 to 3258 deliveries/year. Totally there were 17 519 births and 284 neonatal deaths in the province. Neonatal mortality rate was 16/1000 live births, ranging from 10 to 44/1000 in the different districts, with highest rates in the mountainous parts of the province. Only 8% had home deliveries without skilled attendance, but those deliveries resulted in one-fifth of the neonatal deaths. Conclusion:, A relatively good coverage of perinatal care was found in a Vietnamese province, but neonatal mortality varied markedly with geography and level of care. A remaining small proportion of home deliveries generated a substantial part of mortality. [source]

Changing medical doctor productivity and its affecting factors in rural China

Guiding practice development using the Tidal Commitments

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2006
N. BROOKES rn msc(a) phdcpmhn(c)
The Tidal Model of Mental Health Recovery has contributed to the transformation of nursing practice at the Royal Ottawa Hospital (ROH), a psychiatric and mental health facility in Ontario, Canada. Ten commitments affirm the core values of the Tidal Model. These commitments guide person-centred, collaborative, strength-based practice and they facilitate Tidal teaching. In this paper we illustrate fidelity to the values, principles and processes of the model and the commitments while implementing the model. We share how some of the commitments are realized in our Tidal teaching and provide examples of successes and challenges. [source]

Childhood malnutrition and its predictors in rural Malawi

PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 4 2003
Kenneth Maleta
Summary We prospectively followed up a population-based cohort of 767 rural Malawian children from birth to 36 months to characterise the timing and predictors of malnutrition. Underweight and wasting incidence peaked between 6 and 18 months of age, whereas stunting incidence was highest during the first 6 months of age. After infancy about 40% of the children were underweight, 70% stunted, and about 4% wasted. Small size during the first 3 months of life predicted the incidence of severe underweight (relative risk [95% confidence interval], 1.8 [0.9, 3.4]), severe stunting ( 2.1 [1.3, 3.4]), and moderate wasting (2.0 [1.1, 3.5]). Children with many illness episodes in infancy had a twofold risk for the development of severe underweight and moderate wasting. Severe underweight was further predicted by residence far away from a health facility and moderate wasting by maternal HIV infection. Our conclusion is that the intrauterine period and first 6 months of life are critical for the development of stunting whereas the subsequent year is more critical for the development of underweight and wasting. Strategies combating intrauterine growth retardation, maternal HIV and infant morbidity are likely to reduce the burden of malnutrition in this population. [source]

Fijian seasonal scourge of mango tree falls

ANZ JOURNAL OF SURGERY, Issue 12 2009
Anuj Gupta
Abstract Background:, Mango tree falls are a frequent presentation at any health facility in the South Pacific. This study aims to identify (i) the number of admissions because of falls from mango trees; (ii) epidemiology; (iii) seasonal trend; (iv) injury profile; and (v) hospital care provided. Methods:, Retrospective case review on all mango tree falls related injuries resulting in admissions at the Lautoka Hospital, Fiji during a 1-year period (2007). Patient records were analysed to identify specific injury patterns such as upper/lower limb fractures, spinal cord injury and head injury, caused by mango tree falls. Results:, Thirty-nine cases were identified. Eighty-two percent (n= 32) of the falls occurred in the mango season (June,November). Seventy-two percent (n= 28) of the patients were males and 28% (n= 11) were females. Seventy-six percent were aged 5,13 and only 21% were adults. Also, 77% (n= 30) of the patients were ethnic Fijians and 23% (n= 9) were Fijian-Indians. Sixty-four percent (n= 25) had closed fractures and 17% (n= 7) had open fractures. Fifty-six percent (n= 22) of the fractures were of the fore arm. There were two cases of spinal cord injury, four cases of head injury, one ICU admission and one death. Average hospital stay was 7.56 days. Conclusion:, All these injuries were recreational and the majority in the urban setting. They were all avoidable. [source]

Determinants of adherence to a single-dose nevirapine regimen for the prevention of mother-to-child HIV transmission in Gert Sibande district in South Africa

ACTA PAEDIATRICA, Issue 5 2010
Karl Peltzer
Abstract Aim:, To identify factors that influence adherence to antiretroviral (ARV) prophylaxis by HIV positive mothers participating in the HIV prevention of mother to child (PMTCT) programme. Methods:, Post-delivery 815 HIV-infected mothers aged 18 years and above with babies aged 3,6 months were interviewed in Gert Sibande District, Mpumalanga province, South Africa. Results:, Eighty five percent of the mothers indicated that they had been provided with nevirapine and 78.4% took it before or at the onset of labour and infant nevirapine intake was 76.9%. In multivariate analysis it was found that women with better PMTCT knowledge had a higher perceived confidentility about HIV status at the health facility. They had a term delivery and those who had told their partner about nevirapine had a higher maternal nevirapine adherence. Women who had also told their partner about nevirapine, whose partner was asked for an HIV test and those who knew the HIV status of their infant had higher infant nevirapine adherence. Conclusion:, Adherence to maternal and infant ARV prophylaxis was found to be sub-optimal. Health services delivery factors, male involvement, communication and social support contribute to adherence to ARV prophylaxis in this largely rural setting in South Africa. [source]